A total of 125 candidate vaccines are in various stages of clinical development across the world, led by the US and China. Over a quarter of them are either DNA or RNA vaccines
Globally, the distribution of covid-19 vaccines so far has been biased in favour of rich countries. This inequity is expected to be addressed by the development and production of more vaccines. The World Health Organization has approved only seven vaccines so far, with 125 still under various stages of clinical development, besides 194 in the pre-clinical development phase.
The United States leads the race with 32 candidate vaccines under clinical development by pharmaceutical companies based in the country, including four with foreign collaborations. China comes a close second with 19 candidates. India has seven in development, including three with foreign collaborations—one each with the US, Australia, and Iran.
While RNA vaccines have received most of the attention thanks to the success of the Moderna and Pfizer BioNTech jabs, protein subunit vaccines (such as the Novavax jab) and non-replicating viral vector vaccines (Covishield is an example) account for half of all candidates in the clinical phase (35% and 15% respectively). DNA and RNA vaccines account for another 27%.
Some of these 125 vaccines, if successful, would be ideal for countries or regions where distribution is hard. Nineteen of the vaccines will need only a single dose, while three can be administered orally. All the oral candidates are in the Phase 1 of clinical trials, which tests for their safety. In all, 34 candidate vaccines have cleared the first two phases.
A wider pool of vaccines is a positive in the long term. However, increasing the supply of available vaccines is a more pressing issue, including for India, which is set to reopen vaccine exports shortly.
India has so far administered 926 million doses, second only to China. But the pace of vaccination has been dropping in the last two weeks. In the week ended 6 October, it administered 6.1 million average daily doses, two-thirds of the pace a month ago and the slowest since the third week of August. India has so far administered 65.9 doses per 100 population.
So far, nine states and union territories have administered more than 1,000 doses per 1,000 population. Among these, Himachal Pradesh and Kerala are the only two with over 10 million population. Himachal Pradesh has administered 1,146 doses per 1,000 people while Kerala has given 1,017 doses. Delhi and Gujarat are a close third and fourth with 997 doses and 985 doses respectively. Uttar Pradesh and Bihar lag the rest of the country with 471 doses and 475 doses per 1,000 population, respectively.
Kerala still accounts for 56% of the total new cases in the country. However, all 14 of its districts have shown a decline in cases in the past week, the first time since the cases started going up following Onam festivities. Seven states reported an increase in cases this week, with only Maharashtra and Mizoram reporting significant increases. Cases in Maharashtra grew by 20.8% since last week, owing to a reconciliation exercise on 4 October. As a result, 12 of its 36 districts saw an increase, with Palghar reporting 1,070 cases, three times higher than last week.
Mizoram has been reporting an increasing number of cases for 17 weeks in a row, even though its growth has slowed down to 3.3% in the past week. Aizawl, the capital district, accounted for 61% of Mizoram’s total cases, down from 64% last week. Cases in Saiha and Serchhip dropped by at least 15% this week to 507 and 420, respectively.
India reported 1,789 covid-related deaths this past week, the first time its death toll went below 2,000 since the third week of March. Eighteen states and union territories have reported fewer deaths this week compared to last. Four reported no change, while eight had zero deaths.
Kerala reported the highest number of deaths (846), followed by Maharashtra (351). While Kerala reported 8.6% fewer deaths this week, Maharashtra reported a marginal increase of 1.2%. However, six of Kerala’s 14 districts reported more deaths compared to last week. Deaths in Alappuzha doubled to 124. In Maharashtra, seven districts reported more deaths this week – in five of them – Amravati, Latur, Nagpur, Raigarh, and Sindhudurg, the rise has been less than 5 deaths each. In Satara and Solapur, deaths doubled to 52 and 44 respectively.
Averting a third wave with fast-paced vaccinations remains the most important way to prevent more deaths.